Provider Demographics
NPI:1376705723
Name:NARAYAN, ROJA (MD)
Entity Type:Individual
Prefix:DR
First Name:ROJA
Middle Name:
Last Name:NARAYAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27450 YNEZ RD
Mailing Address - Street 2:STE 100
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92591-4671
Mailing Address - Country:US
Mailing Address - Phone:951-383-4333
Mailing Address - Fax:
Practice Address - Street 1:27450 YNEZ RD
Practice Address - Street 2:SUITE 100
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92591-4671
Practice Address - Country:US
Practice Address - Phone:951-383-4333
Practice Address - Fax:951-506-2361
Is Sole Proprietor?:No
Enumeration Date:2008-06-26
Last Update Date:2016-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA130550207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA004334200Medicaid
CAFQ121ZMedicare PIN